Month: May 2017

Checklists might seem like a rather uninteresting topic, but I contend that they could be one of the most valuable tools we have at our disposal to prevent human error.

Checklists have changed modern medicine in ways many of us don’t realize. In fact, in 2001 a critical care specialist named Peter Pronovost developed a checklist to address the infections cause by placing central lines (an IV used to deliver large volumes). He didn’t intend for the checklist to be all encompassing, but just cover the major issues. What is even more remarkable is that he only had 5 items on his checklist.

Doctors wash their hands with soap

Clean the patient’s skin with antiseptic

Put sterile drapes over the entire patient

Wear a sterile mask, hat, gown, and gloves

Put a sterile dressing over the catheter site once the line is in

Before the checklist became policy Peter asked all the nurses at Johns Hopkins Hospital, where he worked, to note when doctors missed a step in the checklist and after a month the nurses noted that in a full third of cases doctor had skipped at least one step in the checklist.

The hospital then instituted a policy where any nurse could interrupt any doctor who was skipping any step. The results were dramatic. The hospital went from an 11% infection rate to less than 1% rate. Over the 15 month trial period for the checklist the hospital estimated that it prevented 43 infections, 8 deaths, and saved 2 million dollars.

I’ve noticed a similarity in my personal life where seemingly unimportant small steps get missed which lead to larger problems. One area where my family continued to see small mistakes get missed was when we were getting ready to leave our house for an extended period of time. While I didn’t keep detailed information I would estimate that roughly half the time we made some error in either forgetting to pack something important (cell phone charger anyone?) or take care of some household chore (ever leave the trash can full for a week? I have. It’s not pleasant to return to) prior to leaving. So to help solve this problem, you guessed it I built a checklist for leaving on vacation. Since instituting the use of the vacation checklist prior to pulling out of the drive way when we are leaving the house for an extended period of time we have not had one problem.

Here is a link to the PDF version if you like it the way it is and an Excel version If you would like to make changes to personalize the checklist to your circumstances.

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